The health reform legislation provides an unprecedented emphasis on quality measurement, quality improvement, efficiency and value. Value is improved quality at lower cost. For providers, changing their clinical processes to meet these new demands will be essential. Both hospitals and physicians will be facing Medicare value-based modifiers beginning in 2012. Hospitals will further face reductions in payment for avoidable readmissions as well as for hospital-acquired conditions. Because the two payment modifiers for hospitals and physicians, although separate, will be coordinated, this generates an extraordinary motivation for hospitals and physicians to work together. In “
The New Value on Provider ‘Value'” Alice elucidates the many aspects of health reform that reflect these new mandates. She looks at the restrictions Congress has placed on the ability to use cost in comparative effectiveness analysis as an example of a failure of public policy.